Immune System Flashcards
List 2 consequences of an over-active immune system
Chronic inflammation
Allergy
Autoimmunity
List 3 roles of the immune system
Identify and neutralise pathogens
Distinguish between self versus non-self antigens
Distinguish pathological versus non-harmful antigens
Repair the site of any injury or damage
Tumour surveillance
List 3 implications of immune system dysfunction
Increased susceptibility to infection
Increased susceptibility to autoimmunity
Allergies and autoimmunity
Insufficient/incomplete repair
Cell damage and inflammation
Inability to recognise and kill abnormal cancer cells
Who put forward ‘Germ Theory?’
What does it suggest?
Louis Pasteur
That pathogens cause disease
Who put forward ‘terrain’ theory?
Antoine Bechamp
That environment dictates disease (i.e, germs are attracted to the environment of diseased tissue)
Which immune theory helps explain why some people become unwell and others don’t despite the same pathogen exposure?
Terrain theory
Name the two arms of the immune system
Innate
Acquired / adaptive
The innate immune system is split into 2 categories. Name them.
External (first line of defence)
Internal (second line of defence)
The external innate immune system comprises:
1. Physical Barriers
2. Chemical Barriers
True or false?
True
List 4 barriers within the innate (external) immune system.
Skin
Mucous membranes
Sebum
Sweat
Stomach acid
Tears
Mucus and SIgA
Cerumen
Tissue fluids
Vaginal bacteria
List 4 barriers within the innate (internal) immune system.
Phagocytes (monocytes, macrophages, neutrophils, eosinophils)
Mast cells
Fever
Interferons
Complement System
Natural Killer Cells
List 4 barriers within the acquired immune system.
CD4 cells
T Helper Cells (Th1, Th2, Th17, T-regulatory)
B cells
Which arm of the immune system activates inflammation and neutrophils, and suppresses immune activation?
Acquired immune system
List 3 things that effective immunity is dependant upon
- Healthy barrier tissue integrity
- Presence of antimicrobial secretions (tears, saliva, mucus, etc)
- Probiotic bacteria on epithelial surfaces
- Concentrated point-of-entry immune activity (i.e, MALT and GALT)
- Mobilisation of leukocytes
- Inflammation
- Antigen presentation
Where would you find MALT and GALT?
Tonsils
Peyer’s patches
List 3 leukocytes
Macrophages
Dendritic cells
Neutrophils
Mast cells
Are antigen presenting cells contained within the innate or acquired immune system?
Innate (internal)
Many innate immune cells act as antigen presenting cells to the adaptive immune system, which then supports with a more tailored response to a specific threat. True or false?
True
After antigen presentation, naive ____________ cells can differentiate into either Th1, Th2, Th17 or T-reg cells.
T-helper
Th__ cells defend against intracellular pathogens (e.g, viruses)
Th1
Th__ cells defend against extracellular threats (e.g., parasites)
Th2
Which cytokine is associated with differentiation of T-helper cells into Th1?
IL-12
Which cytokines are associated with differentiation of T-helper cells into Th2?
IL2, 4, 5
Th17 cells defend against extracellular pathogens. True or false?
True
Which cytokines are associated with differentiation of T-helper cells into Th17?
IL-1, IL-6, TGF-b
What is the function of T-reg cells?
Modulate and deactivate the immune response.
Where do the majority of peripherally produced T-reg cells originate?
In the GALT
T-reg cells produce 2 cytokines which are inhibitory to helper T-cells. What are they?
TGF-b and IL-10
Either acquired pathway (Th1 / Th2) can down regulate the other, leading to a see-saw effect, referred to as Th1 / Th2 dominance. True or false?
True
Th__ dominance drives chronic inflammation and autoimmunity.
Th1
Th__ dominance drives allergies (i.e, asthmas / atopic triad)
Th2
The optimal acquired immune scenario is a well balanced Th1 and Th2 response, balanced via the T-regulatory cells and various nutrients to down- or up-regulate the balance.
True or false?
True
List 3 clinical indications of low immunity.
Fatigue
Loss of appetite
Weight loss
Fevers
Chills
Aches and pains
Enlarged lymph nodes
What tests could you run to check for low immunity?
WBC (blood)
SIgA (stool or saliva)
Pathogen/antibody testing (blood, urine, stool, microbiome)
List 3 causes / risk factors for low immunity
- Hygiene hypothesis - low pathogen exposure in childhood
- Bottle fed
- Poor nutrition (refined sugars, alcohol)
- Nutrient deficiencies
- Poor gut microbiome
- Immunosuppressant drugs
- Impaired barrier defences
- Emotional, chemical and physical stress (increased cortisol)
- Poor sleep
- Heavy metal toxicity
- Blood glucose dysregulation
- Poor energy delivery systems (i.e, CFS)
- Disrupted methylation
Neonates are born with a TH__ immune bias.
Th2 (allergy)
List 3 key nutrient deficiencies you may find in cases of low immunity.
Vit C, A, D
Zinc
List 3 drugs that can cause low immunity
Corticosteroids
PPIs
NSAIDs
Immune suppressants (methotrexate)
Why is effective methylation important for immune function?
The folate cycle is important for DNA synthesis and repair
A VDR gene SNP results in lower sensitivity to vitamin ___
Vit D
A VDBP gene SNP results in less effective binding / transport of vitamin __
Vit D
What role does vitamin D play in immunity?
Induces cathelicidin antibacterial peptide
Represses inflammatory cytokines
List 3 ways to support immunity
CNM Naturopathic diet
Reduce/eliminate sugar, alcohol, coffee
Maintain a healthy weight
Regular activity, especially outdoors
Support sleep
Reduce stress
Reduce toxic exposure
Prioritise GI health
What role does vitamin A play in immune support?
Supports lymphatic tissues and immune cells
A deficiency in vitamin __ is associated with severe respiratory tract infections, including pneumonia.
Vitamin A
Vitamin __ supports the innate and adaptive immune systems. Deficiency = higher susceptibility to infections.
Vitamin C
Which mineral inhibits viral replication, permeability of barriers and increases anti-viral immune defences?
Zinc
Which probiotics can boost SIgA?
Saccharomyces boullardii
Lactobacilli spp
Which vitamin enhances the innate immune system, increases T-reg cells and dampens excessive immune responses?
Vitamin D
Which vitamin is needed to activate vitamin D?
Vitamin A
Combined use of vitamin A and D reduces inflammation much more effectively and protects tissues from oxidative stress.
Which nutrient, found in medicinal mushrooms and oats, exert immune-modulating and anti-tumour effects?
Beta glucans
Which medicinal mushroom increases immune cells and is cytotoxic to cancer cells?
Reishi
________ is good for use in herpes simplex infection, so can help cold sores.
L-lysine
Which amino acid completes with lysine, so should be avoided if cold sores present?
Arginine
What is cytokine storm syndrome?
Immune hyper-responsiveness.
An excess of pro-inflammatory cytokines
What is metaflammation?
Constant low-grade inflammatory state driven by metabolic state
List 3 co-morbidities that significantly increase the risk of COVID-19
Obesity
Diabetes mellitus
CVD
Non-alcoholic fatty liver disease
List 3 nutrients beneficial in covid / long covid
Quercetin
Resveratrol
Turmeric
Berberine
NAC
Vit D
Colloidal silver
Lugols iodine via salt pipe
Anti-microbial herbs - oregano, garlic, thyme, sage
Which tests might you run for inflammation?
CRP
hs-CRP
ESR
Fibrinogen
Vitamin D
Omega 3:6
Genetic testing
_____________ are locally-acting hormone-like pro-inflammatory messengers made by the oxidation of omega 3 and 6 fats in cell membranes.
Eicosanoids
Name 3 types of eicosanoids
Prostaglandins
Thromboxanes
Leukotrienes
Prostacyclins
Lipoxins
Which inflammatory eicosanoid promotes vasodilation, platelet aggregation, histamine and kinin release?.
Prostaglandin E2 (PGE2)
Which eicosanoids are made via the COX pathway?
Prostaglandins
Prostacyclins
Thromboxanes
Which eicosanoids are made via the LOX pathway?
Leukotrienes
How does the western diet and lifestyle drive chronic inflammation?
High refined sugar increases free radicals and AGEs
High omega 6 / low omega 3 increases PGE2
Bacteria in poor quality processed, pre-chopped foods
Obesity
What do the FADS1 and FADS2 genes code for?
delta-5 and delta-6 desaturase enzymes
(fatty acid conversion)
List 4 risk factors for chronic inflammation
Chronic stress
Poor sleep
Excess exercise / inadequate recovery
Oxidative stress - pollution, smoking, alcohol
High toxic load
Metabolic endotoxaemia
Sex hormone imbalance
Persistent / latent infection
List 4 supplements that may be used in chronic inflammation
Turmeric
Curcumin
Ginger
Plant sterols
Boswellia
Pine bark
Grapeseed
EFA’s (esp. EPA)
Vitamin D
Quercetin
Reishi
Probiotics
Zinc, Mg, B3, B6, vit C
Autoimmunity is present in healthy individuals to eliminate degraded self antigens but comes pathological if there is a breakdown in…
Self tolerance
Some autoimmune diseases are organ specific, whilst some are __________
Systemic
Give an example of a systemic autoimmune disease
SLE
Systemic lupus erthymatosis
In ‘Central Tolerance’, where are self-reactive lymphocytes deleted?
In the thymus
In pregnancy, Th__ immunity predominates.
Th2
Why might systemic autoimmune diseases like SLE be relieved by pregnancy?
Because systemic autoimmune conditions are characterised by Th2 dominant cytokine production and during pregnancy, Th1 predominates, bringing relief.
Which Complex encodes cell surface proteins (HLAs) and plays a key role in antigen presentation?
The Major Histocompatibility Complex (MHC)
Dysfunction of what, is associated with autoimmune disease>
The Major Histocompatibility Complex (MHC)
Why should wheat be avoided in thyroid autoimmune diseases?
Because gliadin in wheat is a molecular mimicker of transglutaminase, which is abundant in the thyroid gland.
List 3 risk factors for autoimmunity
- Emotional trauma (resulting in immune dysregulation)
- Infection
- Gluten
- Environmental toxins
- Vitamin D deficiency
- Dysbiosis
- Intestinal permeability
- Gender (female)
_______ is a key food source of molecular mimicry and inducer of intestinal permeability.
Gluten
What 3 things make up the autoimmune triad?
Genes
Environment
Immune Regulation
________ = a chronic inflammatory disease characterised by autoantibody response to nuclear and cytoplasmic antigens, causing multi-system dysfunction.
SLE
Systemic Lupus Erythematosis
List 4 signs/symptoms of SLE
Fatigue
Joint inflammation
Seizures
Renal damage
Photosensitivity
Malaise
Fever
Butterfly rash on face
How is SLE diagnosed?
By the presence of anti-nuclear antibodies (ANA)
Babies are born with a heightened th___ response, potentially predisposing them to allergic reactions.
Th2
What is the key mechanism in allergic disease?
Heightened Th2 response
List 2 things that may exacerbate high histamine.
Poor detoxification
High histamine diet
List 4 supplements you may choose to use in allergy cases
Quercetin (anti-histamine)
Nettle leaf (anti-histamine)
EPA
Probiotics
Vit D
Magnesium
Vit C
